| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $88.00 | $88.00 | $88.00 | |
Aetna
| Professional | $88.00 | $88.00 | $89.28 | |
BCBS
| Facility | $261.02 | $261.02 | $261.02 | |
BCBS
| Professional | $6.17 | $6.68 | $6.68 | |
Cigna
| Facility | $118.64 | $121.34 | $132.13 | |
United
| Professional | $107.86 | $107.86 | $107.86 |